Evidence-Based Research in Hand Surgery

描述（由申请人提供）：本次K24更新申请将继续在手外科领域获得证据，重点关注桡骨远端骨折（DRF）的治疗，以教授学员循证实践和原则。首席研究员（PI）是一名卫生服务研究员，其兴趣包括循证医学、流行病学和结果研究。PI之前的研究主要集中在肌肉骨骼疾病，如类风湿关节炎和桡骨远端骨折（DRF），尤其是老年人。除了继续对DRF结果进行研究外，这笔拨款还将纳入一个指导计划，向越来越多的初级教师、外科住院医生、国际研究员和医学生教授循证医学和研究方法。该项目的目的是启动一项随机对照临床试验，比较老年DRF患者的两种手部治疗方案的结果，DRF是影响这一不断增长的人群的最常见的伤害。使用掌侧锁定钢板系统（VLPS）进行drf切开复位和内固定治疗的患者将接受全监督手部治疗（FHT）或最低监督自我指导手部治疗（MHT）。本研究的具体目的是：(1)进行一项随机对照试验，比较MHT与传统FHT治疗老年VLPS患者的DRFs，以及(2)建立一个预测模型，以确定将从FHT中受益的患者。来自本研究的数据将为这种损伤的术后处理提供重要信息，并确定DRFs切开复位和内固定后功能结局的预测因素。此外，本研究将提供证据，以帮助医疗保健提供者为DRF患者提供最佳护理，并产生经济数据，以潜在地降低全国的成本。K24奖项的主要重点是应用该项目

DESCRIPTION (provided by applicant): This K24 renewal application will continue to derive evidence in the field of hand surgery by focusing on the treatment of distal radius fractures (DRF) to teach trainees evidence-based practice and principles. The principal investigator (PI) is a health services researcher whose interests include evidence-based medicine, epidemiology and outcomes research. The PI's previous research has concentrated on musculoskeletal diseases such as rheumatoid arthritis and distal radius fractures (DRF), particularly among the elderly. In addition to continuing research on DRF outcomes, this grant will incorporate a mentoring program to teach evidence-based medicine and research methodology to a growing number of junior faculty, surgery residents, international fellows and medical students. The goal of this project is to initiate a randomized-controlled clinical trial to compare outcomes of two hand therapy programs for elderly patients with DRF, which is the most common injury affecting this growing population. Patients treated with open reduction and internal fixation of DRFs using the volar locking plating system (VLPS) will receive fully-supervised hand therapy (FHT) or minimally supervised self-directed hand therapy (MHT). The specific aims of the study are (1) To conduct a randomized controlled trial comparing MHT versus traditional FHT for DRFs in the elderly treated with VLPS, and 2) To develop a predictor model to identify patients who will benefit from FHT. The data derived from this study will provide vital information about the postoperative management of this injury and define predictors of functional outcomes after open reduction and internal fixation of DRFs. Furthermore, this study will yield evidence to assist healthcare providers in giving the best care to DRF patients and generate economic data to potentially reduce costs nationally. The principal focus of this K24 award is to apply this project to educate trainees about evidence-based medicine, epidemiology, statistics and study methodology. entire application (candidate, environment, and research). Include the candidate's immediate and long-term career goals, key elements of the research career development plan, and a description of the research project, as indicated in Part I.4.4.6. Provide an abstract of th entire application (candidate, environment, and research). Include the candidate's immediate and long-term career goals, key elements of the research career development plan, and a description of the research project, as indicated in Part I.4.4.6. CC